Frontline Surgeon: New Zealand Medical Pioneer Douglas Jolly

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Mark Derby discusses New Zealander Douglas Jolly, one of the most gifted and energetic surgeons of the Republican Army’s medical services

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Mark Derby discusses New Zealander Douglas Jolly, one of the most gifted and energetic surgeons of the Republican Army’s medical services

Image courtesy of interviewee. September 12, 2024

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This video provides an extensive overview of a New Zealand-born doctor, Doug Jolly, who made significant contributions to field surgery during the Spanish Civil War and World War II. Born in 1904 in a small town in New Zealand, he initially trained as a doctor, later specializing in surgery. Political turmoil in Europe during the early 1930s led him to engage in anti-fascist efforts, and he served in the Republican army's medical services during the Spanish Civil War, where he performed around 2,000 abdominal surgeries.

Jolly's approach to surgery emphasized speed and system efficiency over individual surgeon skill, leading to improved survival rates for patients with severe injuries. He developed a triage system that prioritized getting patients to operating rooms quickly and involved all medical personnel in the process, arguing that the entire system's effectiveness, not just the surgeon's talent, was critical for patient survival.

Despite his remarkable wartime achievements, Jolly's post-war career in Britain was less prominent, partly due to his leftist views, his Kiwi identity, and a struggle with a bipolar disorder that affected him throughout his life. He authored a significant book on field surgery that remained widely used for decades, influencing modern medical practices in emergency care and surgery. Jolly's legacy includes advancements in surgical techniques and processes that are still in use today in various medical organizations, including Doctors Without Borders.

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Here are five key points from the video:

1. **Background of the Doctor**: The individual spoken about is a New Zealand-born doctor who was born in 1904 in a small, remote town in New Zealand. He grew up in a family without a medical background, as his father was a storekeeper in a gold mining settlement.

2. **Involvement in the Spanish Civil War**: He trained as a doctor and laterwent to London for specialist surgical qualifications. However, when the Spanish Civil War broke out in 1936, he abandoned his surgical studies to serve in the medical services of the Republican army, making a significant personal sacrifice for his beliefs.

3. **Innovations in Medical Practice**: During his time treating soldiers in Spain, he performed around 2,000 abdominal surgeries and developed a system for improving the survival rates of injured individuals by ensuring they received prompt medical care. He emphasized that the speed of treatment was more critical than the surgeon’s skill alone.

4. **Legacy and Influence**: Following the war, he published a highly regarded book on field surgery, which was used by medical professionals during World War II and remained relevant for decades. His system of medical treatment has influenced modern battlefield medicine and is still in use by organizations like Doctors Without Borders.

5. **Personal Challenges and Recognition**: Despite his significant contributions, he faced challenges due to his psychiatric condition (bipolar disorder) and was not permitted to practice surgery in his later career within civilian medicine. His achievements went largely unrecognized, and he lived a quiet life, even as his contemporaries gained fame.

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Here are some key quotes from the video you :

1. **Introduction of the Subject:**
"He was, uh, a compatriot of mine, obviously, a New Zealand born doctor, uh, born, um, right at the beginning of the 20th century in 1904, uh, and into a very small remote town..."

2. **Idealism and Sacrifice:**
"So, uh, uh, you know, an idealistic man and somebody who was prepared to make those kind of sacrifices for what he believed."

3. **Medical Service during War:**
"When the Spanish Civil War broke out mid 1936, he abandoned his, um, surgical studies...and left for Spain to serve, uh, uh, in the medical services of the Republican army."

4. **Impact of His Work:**
"He is believed to have performed somewhere like 2000 abdominal operations...this is an extremely intricate, um, and difficult form of surgery."

5. **Emphasis on the System Over Individual Skill:**
"He said, it's not the surgeon, it's the system."

6. **Regarding Early Treatment Timing:**
"You could be the most brilliant surgeon in the world, and if you’re operating on somebody with gangrene after they’ve been wounded four days, they’re not gonna make it."

7. **Contribution to Modern Medicine:**
"He developed systems for greatly improving the chances of survival of those he treated, and this is really his most important contribution to modern medicine."

8. **Legacy and Recognition:**
"What I find extraordinary is that it remained in use and unsurpassed for 25 years."

9. **Treatment of All Patients:**
"His Christian socialist principles insisted that he treated everybody who had a chance of survival...because they were all human. They were all of equal value in his eyes."

10. **Personal Challenges:**
"...throughout his adult life, he suffered periodically from a psychiatric condition of a bipolar nature."

These quotes capture the essence of the subject matter, highlighting the doctor's background, ideals, contributions to medicine, and his personal struggles.

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He was, a compatriot of mine, obviously,

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a New Zealand born doctor, born,

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right at the beginning of the 20th century in 1904,

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and into a very small remote town, small and remote then,

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and still quite small

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and remote today, in the south island of New Zealand.

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So a long way from anywhere.

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Uh, and his father was the local storekeeper.

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There was in a gold mining settlement, actually,

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so certainly not from any kind of medical background,

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but, went, as a border to the nearest city,

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and, trained as a doctor there.

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Went to London to study

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for specialist qualifications in surgery.

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Uh, and he arrived there in, in the early thirties.

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It was a tumultuous time politically, in Europe.

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And he, he was part of a group, a very impressive group

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of people who were endeavoring

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to confront the Minister of Fascism.

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Uh, and particularly with Christian principles.

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They came from a variety of Christian backgrounds.

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He, himself was a Presbyterian by upbringing,

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and they hoped to, form,

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a synthesis of, Christian

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and Marxist ideals as a, as a means of combating,

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the wave of fascism, which was,

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overtaking one country after another in Europe.

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And he subscribed to these views

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and never in fact departed

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from them for the rest of his life.

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And as a result of that,

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when the Spanish Civil War broke out mid 1936,

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he abandoned his, surgical studies to become a fellow

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of the Royal College of Surgeons,

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and left for Spain to serve, in the medical services

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of the Republican army.

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This was a big decision to make, professionally for him,

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because he was on the point of, of,

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gaining his fellowship and

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therefore qualifying as a surgeon.

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Uh, but he chose to defer, to defer that.

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And in fact, as things turns out, he never did, qualify.

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So, you know, an idealistic man

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and somebody who was prepared to make those kind

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of sacrifices for what he believed.

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I've been in, involved in this subject sort

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of intermittently for something like 20 years.

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And as a result, I've acquired a, a body

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of knowledge, a, a, a, a few shelf full of books on it,

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and in particular, and most usefully contacts with a,

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worldwide community of researchers,

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on the Spanish Civil War, academics and otherwise.

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And I relied on them, really,

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to, to research the subject.

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It wasn't easy. It was a difficult book to research.

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I did the whole thing from,

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Uh, from, from my own,

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from this room right here in Wellington, New Zealand,

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where I live, despite the fact that jolly himself,

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spent nearly all his life overseas in Europe.

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So the research was done at a distance, quite a bit

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of it was carried out during covid,

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which was particularly problematic.

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It wasn't meant that some of the institutions, academic

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and research institutions that I was contacting,

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for information about him, were unable to access their own,

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their own materials.

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Uh, and a a further problem was that, Jo served

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with the international brigades,

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50 different countries speaking, who knows

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how many different languages.

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And so quite a bit of the information about him was in

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languages that I don't speak such as Hungarian and Basque

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and Dutch, and Catalan.

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Um, and I needed to first locate that information

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and second, to be able to

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get it translated to understand it.

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So it was a, demanding research process.

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But I'm, I'm very pleased with the result.

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He was very fit.

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He, he was somebody who, enjoyed physical activity.

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He was a sports star at school.

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He played rugby for his university.

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Uh, he was apparently a very likable character.

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He had a, a string of girlfriends,

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and sometimes more than one at a time.

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And, he and,

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and very, very dear friends who remained friends

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of his, you know, for decades.

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One of them was an e

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Hungarian born economist named Carl Palani.

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Um, later, very distinguished economist,

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as a result of his work in the us.

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And, my book quotes from the very long,

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detailed, intimate letters between,

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and that they exchanged over many years.

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He, he trained, in, in medicine at Otago University,

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which was then the only medical school in this country,

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in the 1920s.

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Many of his teachers, his, his lecturers were,

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ex-servicemen.

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They had served, as, as doctors in World War I.

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And there was a strong tradition of,

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medical service, of medical surgery.

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But the training that he received,

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drew on the experience of that war.

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So he was basically trained to be,

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to be a doctor in World War I.

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Um, he, he was,

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very gifted in surgery,

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and that's what he chose to specialize in.

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So, after he, he graduated in medicine itself,

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he, he left, as I say, for London.

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And he spent several years actually working

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as a house surgeon in various London public hospitals,

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receiving a very broad, general useful,

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clinical training.

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Uh, at the same time as studying for the, legendarily

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rigorous exams for the Royal College of Surgeons.

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Uh, he left for Spain, and

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although not at that point, a qualified surgeon,

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he was immediately appointed, to the, to the role

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of surgeon, and in fact, placed in charge of a, a, a field

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hospital, a mobile field hospital of, of about 12 people,

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doctors, nurses, and, and, and, and technicians,

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and instructed to serve where the fighting was fiercest at

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that point, which happened to be, on the fringes

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of Madrid during Thes Madrid.

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And, this was a, a, a huge, I mean,

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it was really being flung into the deep

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end for somebody like him.

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Uh, he, his, his, his unit,

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represented about, seven different nationalities

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and a number of different languages.

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Not, sometimes no common language between them.

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It was hard for them to communicate until they managed

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to learn enough of each other's language to rub along.

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What is interesting to me is

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that his instructions never really changed for the rest

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of the Spanish Civil War, he was always required to move

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to wherever the fighting was fierce.

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The Spanish Civil War had a long lulls

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on some of its fronts.

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George Orwell describes these periods of boredom

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where all you're doing is conducting a holding action.

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He never had that kind of break in his, in,

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in his time in Spain, because

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whenever biting died down, he was moved off to

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where it was flaring up against somewhere else.

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So, extraordinarily intense.

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In the course of his time in Spain, he is believed

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to have performed somewhere like 2000 abdominal operations.

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He specialized in abdominal surgery

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and people who, who basically had their guts shot open.

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And, this is an extremely intricate,

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and difficult form of surgery.

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This is what he specialized in,

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and he's believed to have carried out more

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of those operations,

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certainly than any surgeon would normally see in their

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entire professional career, but quite possibly more than any

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surgeon had ever performed in history to that day,

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because of the intensity of a warfare,

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that may seem, hyperbolic.

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But, that's a, a well in a,

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well, a well attested view.

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Uh, he developed, he developed systems

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for greatly improving the chances of survival

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of those he treated, and this is really his most important

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contribution to modern medicine.

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He didn't develop a new medical technique.

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He didn't develop a new medical tool,

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a a new kind of operation.

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What he did was alter the whole system by which

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patients are brought to hospital and, and,

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and the role of the surgeon Within that process.

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Uh, in World War I, many people, even

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with very severe wounds, stomach wounds

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and so on, didn't get onto an operating table

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for something like four days.

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Uh, the chances of survival were,

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were very small by that time.

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Jolly wanted them on his table within four hours,

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and he found ways to do this, even if it meant,

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staging his little mobile hospitals,

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which were often in tents

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and caves, in trucks,

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right up close to the front lines so that,

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people could be carried on stretcher by, by mule,

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whatever it took to get them to where they could be treated.

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Uh, and, and he pointed out that this meant that the role

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of the surgeon is not the most important factor.

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He said, it's not the surgeon, it's the system.

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You could be the most brilliant surgeon in the world,

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and if you're operating on somebody with gangrene

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after they've been wounded four days,

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they're not gonna make it.

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But you could be a very novice surgeon,

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and you're operating on someone soon

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after they've been hurt, and you have a chance of saving.

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And, so he said the ambulance drivers,

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the stretcher bearers, the, the, the theater nurses,

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the guys who shave the patients

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before they're operated on, these are all crucial

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to their survival, and they need to be,

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regarded as such.

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So he, he set up a three tier system, of,

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we, we are very first of all, right at the front line.

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There's, a kind of just a couple of guys

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with bandages and, and anesthetic and,

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and so on, to, to treat people immediately and, and,

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and, put a two and a K on gushing wounds.

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Second, is the field hospital a bit further back.

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The one that he headed, and beyond that, further back again,

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are base hospitals where his patients were,

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transferred to.

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As soon as they were stable enough to be moved.

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He had no facilities

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for keeping his patients for any length of time.

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So as soon as they could be safely moved,

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they were moved sometimes on trains,

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on trucks, whatever was involved.

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So the transportation system was critical to his system.

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Uh, he, he would cite his hospitals within reach

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of train lines and, and, and roads and so on.

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Very important in Spain, which had a very underdeveloped,

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infrastructure in those days.

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The first thing he does really is, enlist in,

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in the RAMC in, in the British Army's medical Service,

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because, he has exceptional,

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exceptionally valuable knowledge of the kind of war that,

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Britain is about to be facing.

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That is an aerial war dominated by aerial bombing,

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intensive aerial bombing of built up urban areas.

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Never happened before in history other than in Spain.

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So he had knowledge of the kind of injuries

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and the kind of treatment that was gonna be necessary

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for people, who were, who were victims of that war.

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Uh, and, so he wa he was, sent out

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to the Middle East,

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and he, he spent a number, he spent a couple of years

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or so, several years, running the same sort

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of mobile field hospitals that he'd run in Spain,

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although these ones were much further apart, the desert war,

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involved in transportation across great distances.

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But nonetheless, he was still doing the same kind of thing,

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trying to get his patients

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to him in the shortest possible time,

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stabilizing them, moving them back to,

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to hospitals behind the lines.

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Eventually, once they'd driven the Germans out

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of North Africa, they crossed over into Sicily

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and Italy, and he did the same.

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His hospitals followed them,

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because, as I say, he always worked up by the front lines,

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wherever the, the most intense fighting was taking place.

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And he spent the rest of his war in, in Italy,

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mostly near Naples, where he was the head

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of surgery at a big, hospital that treated both British

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and, New Zealand troops.

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Uh, and then after that, he went back to Britain

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and spent the rest of his career in civilian medicine.

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And extraordinarily,

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he was not permitted to practice surgery.

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He was one of the most experienced,

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and highly regarded surgeons in the world, guys

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that he served with in Spain, whose names you may have heard

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of, because they later became kind

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of pillars of the National Health Service.

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Um, original, original Saxton, Archibald Cochrane,

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these guys got knighthoods.

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Uh, they had, you know, hospitals named after them.

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They, they were hugely regarded,

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and they deserved to be, but what they said is,

13:18.855 --> 13:20.095
Doug Jolly was better than us.

13:20.885 --> 13:23.065
He, he, he, he was a more influential

13:23.215 --> 13:25.145
surgeon, than we were.

13:25.925 --> 13:30.345
And yet, as their careers soared, his stagnated, he,

13:30.405 --> 13:33.185
he did eventually end up as, the medical director

13:33.245 --> 13:35.665
of the largest orthopedic hospital in Britain.

13:36.335 --> 13:39.225
It's called, queen Mary's Hospital place called

13:39.385 --> 13:41.385
Roehampton, outside of London, still there, I believe.

13:41.445 --> 13:45.425
Um, and, so he served there, but very quietly.

13:45.925 --> 13:48.225
Uh, he was by no means innovative.

13:49.125 --> 13:52.825
He was a, you know, he got the job done,

13:53.325 --> 13:56.265
but, he, it, it was a, a bit of a backwater,

13:56.885 --> 14:00.025
and it certainly was, beneath his, his,

14:00.325 --> 14:01.905
his capabilities, what you'd expect, really,

14:01.925 --> 14:03.145
of his wartime career.

14:03.445 --> 14:05.345
He had those same questions in

14:05.345 --> 14:06.385
my mind when I read about him.

14:06.585 --> 14:08.745
I was blown away when I first came across this guy,

14:08.745 --> 14:12.695
and I thought, hell, you know, he's barely known in,

14:12.695 --> 14:14.615
in New Zealand, but then of course, he spent most

14:14.615 --> 14:16.375
of his career over in Europe.

14:16.555 --> 14:17.975
I'm sure he's a big name over there.

14:18.035 --> 14:21.655
He wasn't, his name doesn't appear in the official war

14:21.655 --> 14:22.815
history of New Zealand,

14:23.155 --> 14:24.335
but it also doesn't appear in

14:24.335 --> 14:25.815
Britain's official war history either.

14:26.555 --> 14:30.695
And, you know, he sunk out of,

14:30.715 --> 14:31.775
the historical record.

14:32.805 --> 14:34.375
He's barely known to many

14:34.375 --> 14:35.935
of his own relatives here in New Zealand.

14:36.275 --> 14:37.695
All they know is that he went off overseas

14:37.715 --> 14:39.775
and then sort of, they lost contact with him.

14:40.475 --> 14:45.135
Um, he, I, I think the, you know,

14:45.195 --> 14:48.095
the reason is that the Spanish Civil War itself,

14:48.915 --> 14:50.175
was sometimes,

14:51.215 --> 14:52.435
People looked down on it.

14:52.435 --> 14:53.755
They regarded people more

14:53.755 --> 14:55.795
or less as mercenaries for taking part in it.

14:56.215 --> 15:00.155
Uh, it, it, it, many, once you got back home,

15:00.495 --> 15:02.235
it often didn't count in your favor to say

15:02.235 --> 15:04.275
that you had been a veteran of the Spanish Civil War.

15:04.425 --> 15:07.235
Furthermore, he was an unapologetic lefty

15:07.255 --> 15:09.875
and non-aligned, anti-fascist left winger.

15:10.345 --> 15:13.435
This didn't go well in the medical fraternity in Britain in

15:13.435 --> 15:14.875
the 1950s and so on.

15:15.375 --> 15:19.795
Uh, he was also, he was too much

15:19.795 --> 15:22.395
of a kiwi for the, for the Brits and, and,

15:22.535 --> 15:25.795
and too much of a, of a, of a Brit for the Kiwis.

15:26.215 --> 15:29.795
Um, so both countries kind of tended

15:29.795 --> 15:31.755
to shunt him off, out of sight.

15:32.615 --> 15:37.155
But beyond that, again, the most fundamental reason,

15:37.735 --> 15:39.995
and this came as a great surprise to me when I learned it,

15:40.335 --> 15:42.235
is that pretty much throughout his adult life,

15:42.235 --> 15:44.795
he suffered periodically from a psychiatric condition

15:44.895 --> 15:46.235
of a bipolar nature.

15:46.815 --> 15:50.635
And he would periodically be, be affected

15:50.775 --> 15:53.355
by this condition in wartime.

15:53.485 --> 15:55.915
Oddly enough, it was barely noticeable.

15:56.495 --> 15:59.395
And when it was, it sometimes appeared to work in his favor.

15:59.575 --> 16:02.835
He was famed renowned in Spain for being able to work

16:03.935 --> 16:07.585
nonstop at an extraordinary speed as a surgeon all day,

16:08.045 --> 16:12.955
all night, onto the next day without a break, sort of,

16:13.015 --> 16:17.275
whole, shifts of, of, of, assistants and, and,

16:17.415 --> 16:18.795
and nurses collapsing

16:18.795 --> 16:20.315
with exhaustion on the other side of the table.

16:20.375 --> 16:23.035
And he would just keep going. Ordinary people can't do that.

16:23.095 --> 16:25.715
But when you're on a high from, from,

16:25.735 --> 16:27.395
as he would be then it was possible.

16:28.455 --> 16:31.995
Uh, he, he was also notably courageous,

16:32.095 --> 16:34.515
and he was known for, for

16:37.405 --> 16:39.535
restoring the courage of those who worked with him.

16:39.535 --> 16:41.655
They would hear the bombs dropping closer and closer.

16:41.795 --> 16:43.535
The windows would be cracking in the room

16:43.535 --> 16:44.615
that they were working in.

16:44.615 --> 16:47.615
They'd be terrified, and he would stop what he was doing

16:47.755 --> 16:49.135
and break into the haka.

16:49.135 --> 16:50.295
You know what the haka is, right?

16:50.295 --> 16:51.535
This Maori war dancer,

16:51.635 --> 16:54.095
he would've learned it at high school in the rugby team

16:54.095 --> 16:56.095
because the rugby team would start the game with this,

16:56.395 --> 16:58.855
and he would do this, slapping his chest, stamping his foot,

16:59.605 --> 17:00.695
barking out the words.

17:01.155 --> 17:03.335
And what he was saying is, I'm not scared.

17:03.515 --> 17:06.415
Why should you be scared? Let's defy these bastard.

17:06.485 --> 17:07.615
He's saying,

17:07.995 --> 17:11.635
and, in wartime in Spain, like

17:11.635 --> 17:13.355
that this was actually an effective

17:13.415 --> 17:16.155
and admirable activity in peace time.

17:16.815 --> 17:19.395
It was evidence of, of, of, of derangement.

17:20.295 --> 17:24.595
And from time to time, he, he was obviously,

17:26.065 --> 17:27.345
regarded in that way.

17:28.095 --> 17:29.865
More often, though he was simply depressed.

17:29.865 --> 17:31.825
He was at the, at the downturn of his cycle,

17:31.925 --> 17:35.765
and he would be unable to work, unable

17:35.825 --> 17:37.485
to function, properly.

17:38.045 --> 17:42.895
I need to emphasize that this was not evident

17:43.115 --> 17:44.615
to most of the people who knew him.

17:44.775 --> 17:48.255
I spoke to some of, some retired former,

17:48.255 --> 17:49.575
queen Mary Hospital staff.

17:49.965 --> 17:51.575
They said, yeah, we worked with Dr.

17:51.665 --> 17:53.975
Jolly, wonderful guy. I said, what about the fact that,

17:53.975 --> 17:55.575
you know, he had this mental problem.

17:55.575 --> 17:57.055
They said, you must be thinking of someone else.

17:58.515 --> 18:00.055
We, we never saw any signs of that.

18:00.675 --> 18:03.735
Uh, he was just this rather quiet, reserved, withdrawn,

18:03.735 --> 18:06.775
fellow who, who, who, who got on with the job and went home.

18:07.435 --> 18:09.615
Um, so it,

18:10.525 --> 18:12.975
many people did not observe this.

18:13.235 --> 18:17.135
And, he obviously handled it extraordinarily well.

18:17.255 --> 18:20.135
I have a great admiration for his courage at doing that,

18:20.455 --> 18:21.495
actually, because the medication

18:21.515 --> 18:24.015
for his condition in those days was very poor,

18:24.805 --> 18:26.495
very inadequate, not like it is now.

18:26.495 --> 18:28.135
These days. You can level people out.

18:28.365 --> 18:30.055
Back then, all you could do was sort of

18:30.815 --> 18:31.855
dull them down, really.

18:32.955 --> 18:37.375
Uh, and so he, you know, this would've been a,

18:38.725 --> 18:41.325
a real, a real difficulty in his life.

18:41.545 --> 18:44.205
And he overcame it, I think, heroically,

18:45.875 --> 18:47.975
but it certainly would've counted against him.

18:48.035 --> 18:52.215
Uh, in his civilian career, he saved thousands of lives

18:53.035 --> 18:55.735
in Spain and later in World War II in Spain.

18:55.735 --> 18:58.655
They were, a, a great, many of them were civilians.

18:59.395 --> 19:02.695
Um, Spain was a, a, a total war.

19:02.695 --> 19:05.255
And the, the, the number of civilian casually casualties

19:05.495 --> 19:07.655
exceeded the number of, of, of military ones.

19:07.655 --> 19:10.375
So he operated on little children. He operated on old women.

19:10.955 --> 19:14.535
He operated on everyone who came into his,

19:14.675 --> 19:15.855
to his hospital.

19:17.135 --> 19:19.965
Quite a few, in fact, were, troops from the other side.

19:21.285 --> 19:24.385
So he, he would be operating on a German airman who'd been

19:24.385 --> 19:26.265
trying to bomb it, you know, not very long earlier,

19:26.365 --> 19:27.705
and then had had to bail out and,

19:27.705 --> 19:29.665
and been, been carried in with a broken leg.

19:30.205 --> 19:33.785
He, you know, his, his Christian socialist principles

19:34.545 --> 19:37.345
insisted that he treated everybody who had a chance

19:37.345 --> 19:41.465
of survival, because they were all human.

19:41.465 --> 19:43.305
They were all of equal value in his eyes.

19:44.085 --> 19:46.225
Um, so, so that, that's, you know, that

19:46.245 --> 19:47.425
that's one of his legacies.

19:47.425 --> 19:48.745
Another is the book that he wrote

19:48.995 --> 19:50.305
after the Spanish Civil War,

19:50.305 --> 19:52.585
and right at the outset of World War, world War ii,

19:52.935 --> 19:54.065
it's called Field Surgery.

19:54.205 --> 19:58.345
In Total War. It was a manual of field surgery for the kind

19:58.345 --> 19:59.625
of war that he knew was coming.

20:00.365 --> 20:04.225
And because he knew that, that the surgeons

20:04.225 --> 20:06.545
of his generation had been trained the way he had been

20:06.545 --> 20:09.065
trained in World War I era, military surgery,

20:09.165 --> 20:11.225
and that it was inadequate, inappropriate,

20:11.225 --> 20:13.965
irrelevant, superseded.

20:14.505 --> 20:16.365
So he provided this extraordinary

20:16.365 --> 20:17.405
book, really a very good book.

20:18.475 --> 20:21.245
What, what it was used, it was a bestseller.

20:21.245 --> 20:24.445
It was, it was, used on both sides of the Atlantic

20:24.545 --> 20:27.405
and in fact, right throughout the allied, sector of War.

20:27.945 --> 20:30.725
And what I find extraordinary is that it remained in use

20:31.065 --> 20:33.765
and unsurpassed for 25 years.

20:34.305 --> 20:36.285
It was still in use in the, in the Korean War,

20:36.285 --> 20:38.125
and it was still in use in the Vietnam War

20:38.125 --> 20:39.245
in the late 1960s.

20:39.685 --> 20:43.325
I spoke to a New Zealand surgeon who was in Vietnam,

20:43.385 --> 20:46.965
and he said, of the, the books, the, the, the texts

20:47.005 --> 20:50.535
that he was able to use, Jolly's book was the most useful.

20:51.075 --> 20:52.895
It had been published 25 years earlier.

20:53.235 --> 20:54.655
So that's a considerable legacy.

20:55.635 --> 20:59.375
Uh, and and beyond that, again, I think is the fact that,

20:59.445 --> 21:02.615
that the system that he, that I've described, the system

21:02.615 --> 21:05.975
that he developed, that that emphasized the speed,

21:06.115 --> 21:09.175
the necessity to get patients on your operating theater

21:09.175 --> 21:10.655
quickly,

21:10.875 --> 21:13.255
and that downgraded the status of the surgeon,

21:13.495 --> 21:16.295
upgraded the status of, of others involved in, in

21:16.295 --> 21:18.895
that process, that system is the one

21:18.895 --> 21:20.135
that we now take for granted today.

21:20.135 --> 21:22.255
It's in use in, in a

21:22.255 --> 21:25.895
and e Wards, in former surgery worldwide.

21:26.295 --> 21:28.015
I spoke to, a French surgeon.

21:28.155 --> 21:31.815
He, he's, he's, surgical advisor to, med San Quer,

21:32.595 --> 21:34.175
doctors Without Borders.

21:34.515 --> 21:36.095
He said, absolutely.

21:36.195 --> 21:40.615
We use a, a development of Jolly's principles in our work.

21:41.195 --> 21:43.895
The Red Cross does the same with their,

21:43.895 --> 21:45.255
medical teams overseas.

21:46.685 --> 21:49.435
These guys still work in what is basically the same way,

21:49.855 --> 21:51.475
and he developed it for the first time.

21:51.495 --> 21:52.755
That's quite a legacy, I think.

"A Journey of Sacrifice and Dedication: The Life of a New Zealand Surgeon in Turbulent Times"

00:00:00 - He was, a compatriot of mine, obviously, a New Zealand born doctor, born, right at the beginning of the 20th century in 1904, and into a very small remote town, small and remote then, and still quite small and remote today, in the south island of New Zealand. So a long way from anywhere. and his father was the local storekeeper. There was in a gold mining settlement, actually, so certainly not from any kind of medical background, but, went, as a border to the nearest city, and, trained as a doctor there.
00:00:47 - for specialist qualifications in surgery. and he arrived there in, in the early thirties. It was a tumultuous time politically, in Europe. And he, he was part of a group, a very impressive group of people who were endeavoring to confront the Minister of Fascism. and particularly with Christian principles. They came from a variety of Christian backgrounds. He, himself was a Presbyterian by upbringing, and they hoped to, form, a synthesis of, Christian
00:01:29 - the wave of fascism, which was, overtaking one country after another in Europe. And he subscribed to these views and never in fact departed from them for the rest of his life. And as a result of that, when the Spanish Civil War broke out mid 1936, he abandoned his, surgical studies to become a fellow of the Royal College of Surgeons, and left for Spain to serve, in the medical services of the Republican army. This was a big decision to make, professionally for him, because he was on the point of, of,
00:02:08 - therefore qualifying as a surgeon. but he chose to defer, to defer that. And in fact, as things turns out, he never did, qualify. So, you know, an idealistic man and somebody who was prepared to make those kind of sacrifices for what he believed. I've been in, involved in this subject sort of intermittently for something like 20 years. And as a result, I've acquired a, a body of knowledge, a, a, a, a few shelf full of books on it, and in particular, and most usefully contacts with a, worldwide community of researchers, on the Spanish Civil War, academics and otherwise.
00:02:53 - to, to research the subject. It wasn't easy. It was a difficult book to research. I did the whole thing from, from, from my own, from this room right here in Wellington, New Zealand, where I live, despite the fact that jolly himself, spent nearly all his life overseas in Europe. So the research was done at a distance, quite a bit of it was carried out during covid, which was particularly problematic. It wasn't meant that some of the institutions, academic and research institutions that I was contacting, for information about him, were unable to access their own, their own materials. and a a further problem was that, Jo served
00:03:34 - 50 different countries speaking, who knows how many different languages. And so quite a bit of the information about him was in languages that I don't speak such as Hungarian and Basque and Dutch, and Catalan. and I needed to first locate that information and second, to be able to get it translated to understand it. So it was a, demanding research process. But I'm, I'm very pleased with the result. He was very fit. He, he was somebody who, enjoyed physical activity. He was a sports star at school. He played rugby for his university.

"From Personal Connections to Professional Legacy: The Journey of a New Zealand-Born Surgeon in Times of War"

00:04:16 - He had a, a string of girlfriends, and sometimes more than one at a time. And, he and, and very, very dear friends who remained friends of his, you know, for decades. One of them was an e Hungarian born economist named Carl Palani. later, very distinguished economist, as a result of his work in the us. And, my book quotes from the very long, detailed, intimate letters between, and that they exchanged over many years.
00:04:58 - which was then the only medical school in this country, in the 1920s. Many of his teachers, his, his lecturers were, ex-servicemen. They had served, as, as doctors in World War I. And there was a strong tradition of, medical service, of medical surgery. But the training that he received, drew on the experience of that war. So he was basically trained to be, to be a doctor in World War I. he, he was, very gifted in surgery,
00:05:37 - So, after he, he graduated in medicine itself, he, he left, as I say, for London. And he spent several years actually working as a house surgeon in various London public hospitals, receiving a very broad, general useful, clinical training. at the same time as studying for the, legendarily rigorous exams for the Royal College of Surgeons. he left for Spain, and although not at that point, a qualified surgeon, he was immediately appointed, to the, to the role of surgeon, and in fact, placed in charge of a, a, a field
00:06:20 - doctors, nurses, and, and, and, and technicians, and instructed to serve where the fighting was fiercest at that point, which happened to be, on the fringes of Madrid during Thes Madrid. And, this was a, a, a huge, I mean, it was really being flung into the deep end for somebody like him. he, his, his, his unit, represented about, seven different nationalities and a number of different languages. Not, sometimes no common language between them. It was hard for them to communicate until they managed
00:06:59 - What is interesting to me is that his instructions never really changed for the rest of the Spanish Civil War, he was always required to move to wherever the fighting was fierce. The Spanish Civil War had a long lulls on some of its fronts. George Orwell describes these periods of boredom where all you're doing is conducting a holding action. He never had that kind of break in his, in, in his time in Spain, because whenever biting died down, he was moved off to where it was flaring up against somewhere else. So, extraordinarily intense. In the course of his time in Spain, he is believed to have performed somewhere like 2000 abdominal operations.
00:07:39 - and people who, who basically had their guts shot open. And, this is an extremely intricate, and difficult form of surgery. This is what he specialized in, and he's believed to have carried out more of those operations, certainly than any surgeon would normally see in their entire professional career, but quite possibly more than any surgeon had ever performed in history to that day, because of the intensity of a warfare, that may seem, hyperbolic. But, that's a, a well in a, well, a well attested view. he developed, he developed systems

"Revolutionizing Emergency Medical Care: The Legacy of Jolly's Three-Tier System"

00:08:20 - of those he treated, and this is really his most important contribution to modern medicine. He didn't develop a new medical technique. He didn't develop a new medical tool, a a new kind of operation. What he did was alter the whole system by which patients are brought to hospital and, and, and the role of the surgeon Within that process. in World War I, many people, even with very severe wounds, stomach wounds and so on, didn't get onto an operating table for something like four days. the chances of survival were,
00:09:01 - Jolly wanted them on his table within four hours, and he found ways to do this, even if it meant, staging his little mobile hospitals, which were often in tents and caves, in trucks, right up close to the front lines so that, people could be carried on stretcher by, by mule, whatever it took to get them to where they could be treated. and, and he pointed out that this meant that the role of the surgeon is not the most important factor. He said, it's not the surgeon, it's the system. You could be the most brilliant surgeon in the world,
00:09:41 - after they've been wounded four days, they're not gonna make it. But you could be a very novice surgeon, and you're operating on someone soon after they've been hurt, and you have a chance of saving. And, so he said the ambulance drivers, the stretcher bearers, the, the, the theater nurses, the guys who shave the patients before they're operated on, these are all crucial to their survival, and they need to be, regarded as such. So he, he set up a three tier system, of, we, we are very first of all, right at the front line. There's, a kind of just a couple of guys
00:10:25 - and so on, to, to treat people immediately and, and, and, put a two and a K on gushing wounds. Second, is the field hospital a bit further back. The one that he headed, and beyond that, further back again, are base hospitals where his patients were, transferred to. As soon as they were stable enough to be moved. He had no facilities for keeping his patients for any length of time. So as soon as they could be safely moved, they were moved sometimes on trains, on trucks, whatever was involved. So the transportation system was critical to his system. he, he would cite his hospitals within reach
00:11:04 - Very important in Spain, which had a very underdeveloped, infrastructure in those days. The first thing he does really is, enlist in, in the RAMC in, in the British Army's medical Service, because, he has exceptional, exceptionally valuable knowledge of the kind of war that, Britain is about to be facing. That is an aerial war dominated by aerial bombing, intensive aerial bombing of built up urban areas. Never happened before in history other than in Spain. So he had knowledge of the kind of injuries and the kind of treatment that was gonna be necessary for people, who were, who were victims of that war. and, so he wa he was, sent out
00:11:47 - and he, he spent a number, he spent a couple of years or so, several years, running the same sort of mobile field hospitals that he'd run in Spain, although these ones were much further apart, the desert war, involved in transportation across great distances. But nonetheless, he was still doing the same kind of thing, trying to get his patients to him in the shortest possible time, stabilizing them, moving them back to, to hospitals behind the lines. Eventually, once they'd driven the Germans out of North Africa, they crossed over into Sicily and Italy, and he did the same. His hospitals followed them, because, as I say, he always worked up by the front lines,

The Overlooked Legacy of Dr. Doug Jolly: A Surgeon Among Giants**

00:12:28 - And he spent the rest of his war in, in Italy, mostly near Naples, where he was the head of surgery at a big, hospital that treated both British and, New Zealand troops. and then after that, he went back to Britain and spent the rest of his career in civilian medicine. And extraordinarily, he was not permitted to practice surgery. He was one of the most experienced, and highly regarded surgeons in the world, guys that he served with in Spain, whose names you may have heard of, because they later became kind of pillars of the National Health Service.
00:13:10 - these guys got knighthoods. they had, you know, hospitals named after them. They, they were hugely regarded, and they deserved to be, but what they said is, Doug Jolly was better than us. He, he, he, he was a more influential surgeon, than we were. And yet, as their careers soared, his stagnated, he, he did eventually end up as, the medical director of the largest orthopedic hospital in Britain. It's called, queen Mary's Hospital place called Roehampton, outside of London, still there, I believe. and, so he served there, but very quietly.
00:13:49 - He was a, you know, he got the job done, but, he, it, it was a, a bit of a backwater, and it certainly was, beneath his, his, his capabilities, what you'd expect, really, of his wartime career. He had those same questions in my mind when I read about him. I was blown away when I first came across this guy, and I thought, hell, you know, he's barely known in, in New Zealand, but then of course, he spent most of his career over in Europe. I'm sure he's a big name over there. He wasn't, his name doesn't appear in the official war history of New Zealand, but it also doesn't appear in Britain's official war history either.
00:14:30 - the historical record. He's barely known to many of his own relatives here in New Zealand. All they know is that he went off overseas and then sort of, they lost contact with him. he, I, I think the, you know, the reason is that the Spanish Civil War itself, was sometimes, People looked down on it. They regarded people more or less as mercenaries for taking part in it. it, it, it, many, once you got back home, it often didn't count in your favor to say that you had been a veteran of the Spanish Civil War. Furthermore, he was an unapologetic lefty
00:15:10 - This didn't go well in the medical fraternity in Britain in the 1950s and so on. he was also, he was too much of a kiwi for the, for the Brits and, and, and too much of a, of a, of a Brit for the Kiwis. so both countries kind of tended to shunt him off, out of sight. But beyond that, again, the most fundamental reason, and this came as a great surprise to me when I learned it, is that pretty much throughout his adult life, he suffered periodically from a psychiatric condition of a bipolar nature. And he would periodically be, be affected
00:15:53 - Oddly enough, it was barely noticeable. And when it was, it sometimes appeared to work in his favor. He was famed renowned in Spain for being able to work nonstop at an extraordinary speed as a surgeon all day, all night, onto the next day without a break, sort of, whole, shifts of, of, of, assistants and, and, and nurses collapsing with exhaustion on the other side of the table. And he would just keep going. Ordinary people can't do that. But when you're on a high from, from, as he would be then it was possible. he, he was also notably courageous,

"Courage Under Fire: The Legacy of a Surgeon in Warfare"**

00:16:37 - restoring the courage of those who worked with him. They would hear the bombs dropping closer and closer. The windows would be cracking in the room that they were working in. They'd be terrified, and he would stop what he was doing and break into the haka. You know what the haka is, right? This Maori war dancer, he would've learned it at high school in the rugby team because the rugby team would start the game with this, and he would do this, slapping his chest, stamping his foot, barking out the words. And what he was saying is, I'm not scared. Why should you be scared? Let's defy these bastard. He's saying, and, in wartime in Spain, like that this was actually an effective
00:17:16 - It was evidence of, of, of, of derangement. And from time to time, he, he was obviously, regarded in that way. More often, though he was simply depressed. He was at the, at the downturn of his cycle, and he would be unable to work, unable to function, properly. I need to emphasize that this was not evident to most of the people who knew him. I spoke to some of, some retired former, queen Mary Hospital staff. They said, yeah, we worked with Dr. Jolly, wonderful guy. I said, what about the fact that,
00:17:55 - They said, you must be thinking of someone else. We, we never saw any signs of that. he was just this rather quiet, reserved, withdrawn, fellow who, who, who, who got on with the job and went home. so it, many people did not observe this. And, he obviously handled it extraordinarily well. I have a great admiration for his courage at doing that, actually, because the medication for his condition in those days was very poor, very inadequate, not like it is now. These days. You can level people out. Back then, all you could do was sort of dull them down, really. and so he, you know, this would've been a,
00:18:41 - And he overcame it, I think, heroically, but it certainly would've counted against him. in his civilian career, he saved thousands of lives in Spain and later in World War II in Spain. They were, a, a great, many of them were civilians. Spain was a, a, a total war. And the, the, the number of civilian casually casualties exceeded the number of, of, of military ones. So he operated on little children. He operated on old women. He operated on everyone who came into his, to his hospital. Quite a few, in fact, were, troops from the other side.
00:19:24 - trying to bomb it, you know, not very long earlier, and then had had to bail out and, and been, been carried in with a broken leg. He, you know, his, his Christian socialist principles insisted that he treated everybody who had a chance of survival, because they were all human. They were all of equal value in his eyes. so, so that, that's, you know, that that's one of his legacies. Another is the book that he wrote after the Spanish Civil War, and right at the outset of World War, world War ii, it's called Field Surgery. In Total War. It was a manual of field surgery for the kind of war that he knew was coming. And because he knew that, that the surgeons
00:20:06 - trained in World War I era, military surgery, and that it was inadequate, inappropriate, irrelevant, superseded. So he provided this extraordinary book, really a very good book. What, what it was used, it was a bestseller. It was, it was, used on both sides of the Atlantic and in fact, right throughout the allied, sector of War. And what I find extraordinary is that it remained in use and unsurpassed for 25 years. It was still in use in the, in the Korean War, and it was still in use in the Vietnam War in the late 1960s. I spoke to a New Zealand surgeon who was in Vietnam, and he said, of the, the books, the, the, the texts

"Legacy of Innovation: The Enduring Impact of Jolly's Surgical System"

00:20:51 - It had been published 25 years earlier. So that's a considerable legacy. and and beyond that, again, I think is the fact that, that the system that he, that I've described, the system that he developed, that that emphasized the speed, the necessity to get patients on your operating theater quickly, and that downgraded the status of the surgeon, upgraded the status of, of others involved in, in that process, that system is the one that we now take for granted today. It's in use in, in a and e Wards, in former surgery worldwide. I spoke to, a French surgeon.
00:21:51 - doctors Without Borders. He said, absolutely. We use a, a development of Jolly's principles in our work. The Red Cross does the same with their, medical teams overseas. These guys still work in what is basically the same way, and he developed it for the first time. That's quite a legacy, I think.

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Frontline Surgeon: New Zealand Medical Pioneer Douglas Jolly

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